This review evaluates lung lesion marking techniques used to guide sublobar (parenchyma-preserving) resection of early-stage lung cancers via thoracoscopy, comparing CT-guided transthoracic methods (dye injection, fiducials, hook wires) against conventional and robotic bronchoscopic approaches.
Transthoracic marking is widely used but carries risks including pneumothorax, air embolism, dye dissipation/extravasation, and hook-wire dislodgement; robotic bronchoscopy is characterized as a safe and accurate alternative that can mark lesions in the same procedural setting as resection, though availability and learning curve are limiting factors.
This is a narrative review without a systematic search strategy or meta-analysis, so no comparative efficacy or complication-rate data are pooled. Robotic bronchoscopy access is limited globally, and evidence on long-term oncologic outcomes tied to marking technique choice is not addressed.
For thoracoscopic sublobar resection of small, subsolid, or deep lung lesions, preprocedural marking is essential — robotic bronchoscopy offers a same-session, lower-complication alternative to transthoracic methods where available. Modality choice should be driven by local expertise and resources, as no single technique is universally superior.
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